Effectiveness and safety of levodopa-entacapone-carbidopa infusion in Parkinson disease: A real-world data study

Eur J Neurol. 2025 Jan;32(1):e16535. doi: 10.1111/ene.16535. Epub 2024 Oct 28.

Abstract

Background and purpose: Levodopa-entacapone-carbidopa intestinal gel (LECIG) infusion is a recently developed device-aided therapy for advanced Parkinson disease (PD) patients. The aim of this study was to report real-world evidence about the effectiveness, tolerability, and safety of LECIG in PD patients.

Methods: A multicenter observational retrospective study of the first patients who initiated LECIG in Spain was performed. All neurologists with an experience of at least two patients treated until 30 March 2024 were invited to participate. Data about effectiveness and safety from the medical records (V0, pre-LECIG; V1, initiation of LECIG; V2, post-LECIG follow-up) with a total of 246 variables were collected.

Results: Seventy-three PD patients (61.6% males, 70.1 ± 9.1 years old) from 21 Spanish centers with a mean disease duration of 14.4 ± 6.3 years (range = 5-31) were included. Twenty-six patients (35.6%) were switched directly from levodopa-carbidopa intestinal gel. The mean exposure to LECIG was 177.3 ± 110.5 days (range = 7-476). The mean daily OFF time decreased from 5.2 ± 3 (pre-LECIG) to 1.9 ± 1.8 (post-LECIG; n = 66, p < 0.0001). Global improvement was observed in >85% of the patients. No significant change was detected in the levodopa equivalent daily dose from V0 to V2. Only 7% received 24-h infusion, and 24.7% required more than one cartridge per day at V2. Thirty-four patients (46.6%) had at least one adverse event related to LECIG and/or the device system. Five patients (6.8%) discontinued LECIG.

Conclusions: LECIG was safe and effective in advanced PD patients.

Keywords: Parkinson disease; effectiveness; infusion; levodopa–entacapone–carbidopa; safety.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antiparkinson Agents* / administration & dosage
  • Antiparkinson Agents* / adverse effects
  • Carbidopa* / administration & dosage
  • Carbidopa* / adverse effects
  • Catechols* / administration & dosage
  • Catechols* / adverse effects
  • Drug Combinations*
  • Female
  • Gels
  • Humans
  • Levodopa* / administration & dosage
  • Levodopa* / adverse effects
  • Male
  • Middle Aged
  • Nitriles / administration & dosage
  • Nitriles / adverse effects
  • Parkinson Disease* / drug therapy
  • Retrospective Studies
  • Spain
  • Treatment Outcome

Substances

  • Levodopa
  • Carbidopa
  • Antiparkinson Agents
  • Catechols
  • Drug Combinations
  • entacapone
  • carbidopa, levodopa drug combination
  • Nitriles
  • Gels